Abstract 18647: Gender Differences in the Relationship Between Depressive Symptoms and Coronary Events in Acute Coronary Syndrome Patients

Abstract

Background: Despite a decrease in acute mortality, a considerable number of patients who have acute coronary syndrome (ACS) go on to experience major adverse coronary events (MACE). The objectives of this prospective ACS study are to examine relationships between depressive symptoms and risk of subsequent MACE and most importantly, examine if gender differences exist. We hypothesized that the presence of depressive symptoms will be related to increased risk of MACE and gender differences will exist. METHODS: We analyzed 1194 patients enrolled during hospitalization for ACS. Patients were screened using the Beck Depression Inventory-II. Annual telephone interviews were conducted to obtain MACE data. MACE was defined and death, stroke, AMI, re-admission for ACS requiring vascularization. Basic descriptive statistics were determined and analysis of risk for MACE was conducted with logistic regression. Logistic regression models for occurrence of MACE included gender and depression as the independent variables. An interaction term for gender-by=depression was included in the model to test if the association of depression and MACE varies by gender. RESULTS: Of the 1104 with MACE data, 16% reported MACE. Of those, 33% were women and 67% were men. Women were older (64.19 ± 13) than men (61.06 ± 11.60) (p<0.0001) and were more likely to report a diagnosis history of diabetes (p=0.009), hypertension (p<0.0001), and stroke (p=0.005) than men. Men were more likely to report current smoking (p<0.0001) and alcohol (p<0.0001) statuses than women and were more likely to report a history of coronary angioplasty (p=0.001). Depressive symptoms were significantly related to MACE with a two-fold greater odds of subsequent MACE (OR 2.56, CI 1.80-3.63, p=<0.0001). Both men (OR 2.82, CI 1.85-4.28, p<0.0001) and women (OR 2.09, CI 1.12-3.91, p=0.020) experience greater odds of MACE when depressed. The association between depression and MACE did not vary significantly by gender (p=0.394). CONCLUSIONS: To conclude important gender differences were noted, but the association between depression and MACE did not vary significantly by gender. This study has the potential to add to the growing body of literature that suggests that gender-related differences exist with regard to ACS.